Health impacts of solid fuel use in Ghana: A nationally representative assessment of cooking-related burns

Abstract

BACKGROUND AND AIM Burns and burn-related injuries are still a major public health problem. Every day, over 30,000 people suffer new severe burns worldwide. Low- and middle-income countries (LMICs) bear a disproportionate burden (70%) of these burns. While burn prevention strategies have successfully been implemented in high-income countries, a paucity of data regarding the incidence and risk factors of burns in LMICs limits their expansion. Here, we aimed to describe the country-level incidence of serious cooking-related burns in Ghana and to identify household-level risk factors for adults and children. METHODS We conducted a nationally representative household energy use survey in Ghana in 2020. The final sample included 7,389 households across 370 enumeration areas in all 16 regions of Ghana. An adapted version of the Global Alliance for Clean Cookstoves Burns Surveillance Module was administered to each respondent. We computed incidence rates and 95% confidence intervals using the Byar’s approximation and conducted univariate logistic regression to identify potential risk factors. RESULTS Out of 7,389 households, we documented 129 serious cooking-related burns which had occurred in the previous 12 months. Slightly more than half (55%) of those burns occurred among adults. The incidence rate (95% CI) of cooking-related burns per 1000 person-years was 9.7 (7.7; 12) and 11 (8.5; 14) among adults and children respectively. Among adults, the odds (95% CI) of experiencing a serious cooking-related burn were 2.29 (1.02; 5.14) and 2.40 (1.04; 5.55) times higher among primary wood and charcoal users respectively compared to primary LPG users. No children burns were documented in households where LPG was primarily used. CONCLUSIONS Using a nationally representative sample, we characterized the incidence of cooking-related burns across demographic groups in Ghana. Solid fuel use compared to LPG use doubled the odds of experiencing such burns. KEYWORDS Burns; Solid fuel; Energy access; LMICs; Ghana